Title
Survival after an amniotic fluid embolism following the use of sodium bicarbonate.
Link to article in PubMed
Author(s)
Evans, Sorcha
Brown, Brigid
Mathieson, Matthew
Tay, Stan
Abstract
Amniotic fluid embolism (AFE) is a rare and potentially fatal complication of pregnancy. In this case report, we highlight the successful use of sodium bicarbonate in a patient with an AFE. We present a case of a 38-year-old mother admitted for an elective caesarean section. Following the delivery of her baby, the mother suffered a cardiac arrest. Following a protracted resuscitation, transoesophageal echocardiography demonstrated evidence of acute pulmonary hypertension, with an empty left ventricle and an over-distended right ventricle. In view of these findings and no improvement noted from on-going resuscitation, sodium bicarbonate was infused as a pulmonary vasodilator. Almost instantaneous return of spontaneous circulation was noted, with normalisation of cardiac parameters. We propose that in patients suspected with AFE and who have been unresponsive to advance cardiac life support measures, and where right ventricular failure is present with acidosis and/or hypercarbia, the use of sodium bicarbonate should be considered.
Publication information
BMJ Case Rep . 2014 May 30:2014:bcr2014204672. doi: 10.1136/bcr-2014-204672.
Date Issued
2014-05-30
Type
Journal Article
Journal Title
BMJ case reports
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